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Title: Introduction to International Health
Country: Belgium
Institution: Belgium - Antwerp Institute of Tropical Medicine
Course coordinator: Ludwig Apers
Deo Katsuva Sibongwere
Date start: 2022-09-05
Date end: 2022-12-23
About duration and dates: 16 weeks
Classification: core course
Mode of delivery: Face to face
Course location: Institute of Tropical Medicine
ECTS credit points: 20 ECTS credits
SIT: SIT: 595 hours
Contact hours: 367 hours
Self-study (individual or in group): 228 hours
Language: English
Description:
By the end of the core course, students should be able to:

1. critically reflect on the collection, analysis and appraisal of qualitative and quantitative data relevant for the improvement of health and health care equity.
2. identify and analyse interrelated determinants of health and major health concerns of populations in a trans-disciplinary perspective in low- and middle-income settings and on global level.
3. propose sustainable improvements of health systems addressing inequities and considering diverse intercultural settings as well as social, legal and ethical responsibilities.
4. describe the role, decision-making process and impact of global health policy actors.
5. collaborate and clearly communicate in a multi-disciplinary and multi-cultural setting.



Specific objectives
By the end of the core course, students should be able to:

1. (tropEd) critically reflect on the collection, analysis and appraisal of qualitative and quantitative data relevant for the improvement of health and health care equity.

- apply quantitative and qualitative research methods relevant for public (international/global ?) health
- critically analyse disease control programmes, applying scientific tools and methods

2. (tropEd) identify and analyse interrelated determinants of health and major health concerns of populations in a trans-disciplinary perspective in low- and middle-income settings and on global level.

- discuss determinants of health in general and of health care seeking behaviour in particular
- analyse the main biomedical, clinical and epidemiological aspects of the major health problems in low and middle income countries in order to manage their prevention and control at population and individual level
- analyse the main epidemiological, programmatic and health system aspects of reproductive health, child health and healthcare in emergency situations (only for clinical orientation)
- organize field laboratories and review their performance (only for biomedical orientation)

3. (tropEd) propose sustainable improvements of health systems addressing inequities and considering diverse intercultural settings as well as social, legal and ethical responsibilities.

- organise primary health care services taking into account local priorities and resource availability as well as the perspective of communities and patients

4. (tropEd describe the role, decision-making process and impact of global health policy actors

- discuss the major issues in international health policy and development cooperation

5. (tropEd) collaborate and clearly communicate in a multi-disciplinary and multi-cultural setting

- manage communication and teamwork in a multi-disciplinary setting
Focus or specific features:
The ITM core course is structured in four course components. In the fourth course component, students choose between option A (clinical orientation) or B (biomedical orientation).
Each course component includes one or more blocks. The first course component “Public Health and Health Systems” introduces concepts and tools of public health and health systems, vertical analysis and research & evaluation methods in public health. In the second course component “Epidemiology and Statistics”, theories and methods of epidemiology and statistics are discussed and applied. Data analysis with the software R is introduced. The third course component focuses on ”Infectious Diseases”. It contains blocks on Vector-borne diseases, HIV/AIDS , TB, Bacterial infections and antimicrobial resistance). The fourth course component “Population-Specific Interventions” for the clinical orientation includes three blocks on Child Health, Reproductive Health and Public Health in Emergencies ; and, for the biomedical orientation, it deals with Field Laboratory Preparedness and Emergency Preparedness.
In the thematic blocks, clinical aspects of major health problems are combined in a balanced way with a public health approach to disease control, health service organisation and management.
Group assignments allow students to work in an interdisciplinary way.
Assessment Procedures:
Participants are assessed through group assignments, essays, and tests for formative and summative assessments. The weight of each block is proportional to the student investment time. See table 3
Students pass when they succeed in all 4 Course Components with at least 50% for each of them.
Students who fail a test are entitled to a re-sit exam not later than two months after the end of the course.
Content:
Each core course has its special emphasis (i.e., medical, social sciences, health systems, etc.).

● Introduction and learning skills (0.5 to 1.5 ECTS credits).
● Concepts, theory and methods for global health research (quantitative and qualitative) (4.5 to 7.5 ECTS credits).
● Global health concerns (e.g. SDGs, health emergencies, communicable and non-communicable diseases, sexual and reproductive health and rights, environmental health, injury), and response strategies (4.5 to 7.5 ECTS credits).
● Global health policies, health systems, their management, financing and strengthening (4.5 to 7.5 ECTS credits).
Methods:
- Contact hours (61,7% of SIT) are a combination of didactic lectures, demonstrations, problem-based learning, and interactive classes often as discussions on cases and on articles or book chapters read during self-study time, group work

- Self-study, critical reading, group work, assignments represent 38,3% of the SIT.

Examples of group assignments:
• Vertical analysis: systematic analysis of a disease problem, developing an epidemiological model and control interventions.
• General exercise on emergency settings, developing an action plan for an emergency situation in conflict area and/or epidemic
• Discussing different strategies in prevention and treatment of HIV/AIDS (eMTCT cascade, timely HIV testing, …)
Prerequisites:
Academic degree
Applicants must be holder of a university degree of minimum 4 years equivalent to 240 ECTS (referred to as a Master’s degree in the European Union) in medicine or health sciences such as pharmacy, nursing, midwifery, health economics, medical sociology, medical anthropology and biomedical sciences.
Language proficiency
Required level for English: TOEFL 580 (paper-based), 230 (computer-based) or 88 (internet-based), IELTS 6.5 or equivalent. (ITM Toefl Code 7727).
Note that native English speakers are exempt from these language requirements. Applicants whose first language is not English are equally exempt if they have obtained 60 credits from a higher education programme taught in English. Non-native English speakers are also exempt from the English language requirement if they have a higher education diploma from a Flemish Community higher education institution.
Attendance:
A maximum of 60 students is admitted. No limitation for tropEd students.
Selection:
Admission on first come, first served basis.
A selection process is only applicable for scholarship candidates (see below).
Fees:
EU/EFTA 2020 Euro, non EU/EFTA 6100 Euro.
Scholarships:
In view of continuing into the Master of Science in Tropical Medicine (MTM) or the Master of Science in Public Health orientation Health Systems and Disease Control (MPH-HSDC), a number of scholarships from the Belgian Directorate General for Development (DGD) are available for core course participants from LMIC’s (see www.itg.be ). The scholarships are attributed following a selection organised in May of each year. Candidates have to introduce a motivation: why they wish to do the course (as part of the MTM or MPH-HSDC), how they envisage it will help them in fulfilling their future career objectives, indicating academic experience relevant to the content of the course and specific elements of the programme that appeals to them, and proposing a provisional study plan for the MTM or MPH-HSDC with selected advanced courses and a thesis topic.
Major changes since initial accreditation:
Management
- Since 2019, the course has a new coordinator (Deogratias KATSUVA SIBONGWERE) and since 2020 a new course leader (Ludwig APERS).
Structure
- Since 2020 interrelated blocks have been organised in 3 course components. The third block offers a choice in function of the clinical or biomedical background or interest of the participants.
- Since 2022 the first course component is split in two: Fundamentals of Public Health and Epidemiology and Statistics are now two separate course components. This implies that students need to pass for Epidemiology and Statistics to obtain the credit certificate.
Content
- Two new blocks have been added: since 2019 “Bacterial Infections and Antimicrobial Resistance” was added to the course component Infectious Diseases in view of its global importance; since 2020 a block on Field Laboratory Preparedness added to in order to meet the learning objectives of biomedical participants
- The contents of thematic blocks (Vector-borne diseases, HIV, TB, Antimicrobial resistance, Child health and Reproductive health) have been reassessed and made more public health oriented and aligned to the objectives of the course but also avoiding duplication with the content of the course “Tropical Medicine and Clinical Decision Making- TMCDM” organised for clinicians.
- Specific lectures on COVID-19, Quality of medicines in LMICs, Integration and decolonisation, Gender in public health, Climate change, and International Humanitarian Law were added to the curriculum since 2020.
Learning Methods
- Online teaching and hybrid teaching have been introduced during the Covid-19 pandemic and are partially maintained. External lecturers can avoid medium & long distance travel and teach online. The preferred modality for students is face-to-face but they can attend the course online if needed. This arrangement has improved the attendance of course participants. Class rooms have been equipped as “Zoom-rooms”.
- The “Flipped classroom-method” is being used by more and more lecturers to allow participants to prepare for a session at their own pace and in function of their learning needs. Contact hours are then used more for clarifications, applications, exchange and discussions.
- Interdisciplinary exchange sessions on health system issues and on climate change are organised jointly with students from the MPH-Health Systems and Disease Control (mostly experienced professionals from LMICs). These exchange sessions have proven to be very positive.
Assessment
- The use of group and individual assignments in the different blocks has been strengthened. Attention went to introducing more variation in assignments, to group composition and to provision of clear feedback at the end of group work.
- The assessment procedures is evolving towards more varied methods, including the scoring of group work and presentations.
- Written exams have been prepared and conducted via ITM’s Learning Management System “Moodle”.
- Remote online assessment with a proctoring system is now being used whenever needed.
Learning support
- A comprehensive student handbook is updated every year. Block coordinators have been asked to systematically share a “Block summary” with participants before the start of a block.
- New didactic materials for child health and reproductive health blocks have been acquired.
- All course material is placed on Moodle, and stays available to our alumni up to 3 years after the course. Paper printing is limited as much as possible
Student evaluation:
The course is being evaluated in 3 ways:

- a feedback session with a small group of students at the end of each block
- an overall evaluation through an anonymous written questionnaire at the end of the course
- a final oral feedback with all participants to discuss global aspects

Feedback is communicated to lecturers and analysed during the steering-group meetings which take place twice a year: just after the course and again when starting the organisation of the next course. Adjustments of content, methods and teaching staff are made accordingly.

Positive aspects:

- Participants are very satisfied with the completeness and the complementarity of different blocks making this course a stand-alone for an international career.
- Participants found the whole staff, teachers, coordinator and secretary team very welcoming and warm and set a big example; far better than in other courses or other universities where they studied before.
- Vertical analysis and emergency exercise were mentioned as very educational integrated exercises
- Request of more joint sessions with MPH participants

Remarks that need improvement:

The following criticisms have been addressed to a large degree:

- Overlap in content between lecturers has been discussed and addressed.
- Most assessments are organised at the end of the course, quite some time after the completion of the block. Participants would prefer assessments immediately after a block. Reflexions are taking place to improve the assessment methods and the timing.
- For TB block, participants ask for ‘clinical basics’ before going into detail. This will be addressed from the session starting in September 2022.
Lessons learned:
- Hybrid teaching and online assessments have considerably increased the attendance and the flexibility for participants who cannot physically attend the course for different reasons (visa issues, illness, personal issues, …).

- The presence of MTM participants from LMIC has been an opportunity for enhanced sharing of experiences from different contexts.
tropEd accreditation:
Accredited in Valencia 2001. Re-accredited in Bergen May 2006, and was reaccredited at the Barcelona meeting in 2011 and in Amsterdam in October 2016. Re-accreditation Bagamoyo, June 2022.
Remarks:
This course can be considered as a stand-alone short course or a core course of ITM’s Master in Tropical Medicine (MTM) or Master in Public Health orientation Health Systems and Disease Control. Both masters are in the broad field of International / Global Health and integrate mobility in the tropEd network and thus welcome tropEd students. The core course certificate is valid for application to the master programme during 5 years.

Note: this course is also part of a postgraduate certificate programme for medical doctors, leading to a postgraduate certificate in tropical medicine & international health. The second part (10 ECTS) of this postgraduate certificate programme focuses on tropical medicine and clinical decision-making.
Email Address: bbroucker@itg.be
Date Of Record Creation: 2012-01-19 22:28:22 (W3C-DTF)
Date Of Record Release: 2012-01-20 04:52:21 (W3C-DTF)
Date Record Checked: 2016-11-03 (W3C-DTF)
Date Last Modified: 2023-07-17 12:39:20 (W3C-DTF)

Fifteen years of the tropEd Masters in International Health programme: what has it delivered? Results of an alumni survey of masters students in international health

L. Gerstel1, P. A. C. Zwanikken1, A. Hoffman2, C. Diederichs3, M. Borchert3 and B. Peterhans2

1 Royal Tropical Institute, Amsterdam, The Netherlands
2 Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
3 Institute of Tropical Medicine and International Health, Charite – Universit€atsmedizin Berlin, Berlin, Germany